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HomeMy WebLinkAbout002-1028-90-000 (2)^^ PRIVATE SEWAGE SYSTEM County St. Cf01% SIFIN Ld a.mxy oiaam INSPECTION REPORT un LLM NO B2SBEB GENERAL INFORMATION (ATTACH TO PERMIT) rude Pumo NO OR ELWIV Led I 15 wtlymll gOL vm'e' rtn Terry Helgeson TOWN OF BNoALOWIN 002-1028-90-000 eMEi.Fop au eu. Ernosel Tn eI �mrte.�w..w�N14.2916209B TANK INFORMATION I ELEVATION DATA TANK SMACK INFORMATION ON SOIL AIMORPTNIN SYSTEM IL BLUR CM S;m NO m SOIL COVER unByrNlGITnry a Mound Or AliMx Symme Only dmlP® ceps m me �I.I wmm Turn, Ern. a Y. J m Y.. COMMENTS (meeeme.eleep.rmneymenLelC) InepxwnD iAAIL(I/IL/LO mereo xs L� 25$3CTYROwewn E Exls} hnn�d M UH I ) An Red oee�mn- N "�cd h a ylelee=u•urNnyln 475 emm)422' 0f Coru on CAI I, Flee toolnROr rMt a Onn l �1. Ulu A Use nmersieem,eeemnnzl mlumnl EN°"' �'0 lw\% H l 0. mmt NfK4 gclnu� pCurtibc2 MAY 222020 o. coomr 64N-Zod?�O- �29 c In Intluetry Snnbes UnNan AOoewnn bn Ave Mc I Fo Boe,16i r mnei.on T 591 t6 r DbCat)on rxn.a.n NIme<, "�` mwn��e naaio ".I Add...vfma..m nw m.n,b.eme u vn ,.0 pmA III �a.n emE eSenl _10,?.8�w'GI g00_q.{{�L6 -- �le—b.xw.A, �- 0 �S�LI �u&lw,Senr" TAN N R,GI—e W yq of Bidding len..x All nn eyy,n m2 AmAy Wei nnv-Numka of oelrmm. Va18 County 4) es� nd 6) P=Y.*-u, (em Numm Ave/ u.r u.S .13q 1 l�LdF IIne B N.{pllnbl) [Ny.r .um0F6,n1 7 r. .v. .I r..Mmr.nn mmWnavmwnm— e•Qmwm>rsl � OMmne<I.m.rv„mu.>on NI It m.n.m.,.q tl -- !i! �nn wn ,, ww7 u ie�25]We 71S2317311 MyllyeOWIW s.4PMIlLddI ao +YfF�' ��M UUU WArN�, N WYNb¢. eml..+'=aa SYSTEM PAGE E OF SOIL EVALUATION eo SITE MAP PLOT PLAN O Pxa[c, xaMe T•, oenexrww ae° an.ae.xwx•xm•x.nxxamnwnxa�iei.+. Pi"~,l I MTM eime•M 90MM xxs aWa ) r w•cT ° e. e e. n e.i, sr ' aYi�Wu�IN�' wNMmele•w�wuip ti,Trto•w BxewYrcuntleMrc��ntleWtlMalnbtlf. *4o ok 00 `7 Cn 82 Ew�Ys a A i 00 0 f SAoa -- _ — ciUPY I %57 _ - - 0MPSSETBelZISUES LAB)100'SY46MSlo4 - cmku�u w. M PAGE 20F ❑ SOIL EVALUATION eui.:raa o- W SYSTEM m ❑ SITE MAP PLOT PLAN PaOACT MOME ie, o GNFWW AM& & W IMMW Wunw WMMMOM MMM f' Mp, MMMM I nSTM Stmd (TIMM YO &MN ) �� E.rwo+hr.m.t N E e.�wre....._4i-466-W Ms...M —1�— "���-.i�fr Mo-MVM� n: ww0"r.:�ai� r_�iU_ wMwMe Mwa.wi o wM. ""�a w°"°M.::M. Y19]Bi�Gtl[ enr..pwM.WwMn W,.MwMM. Maw AV 1539�GT *wk rc�e�c� I -I- loc =' lal I SMd A �I 11DOSP5 SET6+1u( i55u�5 WL) IOo' 5Yc'En l6&'4- PAGE 4 OF 4 Holding Tank Management Plan IMPORTANT: The OMier of this holding tank(el shell be responsible ter Ma perpetual open lOn ew Mall nn0 Pu Nustto lenkl6) natural d SPS 382- WIN Austin CCde Pursuant to SPS 383 W(2), nNl be considered a human IF hmeM it not nual arrol in xwraance with lNe approved metlement part FWhwmae, all Impel am maintenance acidltlee shop be Porname! W a malamute POWfSsM lnw In acpkanse win Si 383,53(3), Also Adam Cotle Estimated pally WBSWW&Wf Flow= 46O gPd se,con CpackNal INSPECT EVERY 3 YEMS YPe of use ape of sYNm n Iurlro fenev*yy V a n (t o uwmps ria Offirw MaMrfaIgue(Ia peaks, brawl cveoee setc) nWle, efc) nageof lWpw Oe Ias(I brsamrai Man, etc) billlW etlwlllOF sic) nplecl or Imprperuse ae, samurai upecled on mill OpnpMema IF e„ wlnrr9, runnalirls. eNnaM1ea, wnirole, bmen, alarms, ek ) in aurfack abchmpe Of affluent or savage loot Into structure served SERVICING FREQUENCY The lank(sl shall be pumped by a ourtoed septage aemclnp operator licensed under a 28145 wild Shale Dwhen the wpoeelolnc wnWerhIn alltbepunentto NR113,Wlw Ione Admo Codeot InIN Invarl of the Unit(*) Tank Tank Pumping reports stead pre submitted b Me pmpar bul governor unit In summer with SM 3&l0 Wis. Admen.Coda. Repodany OPmponenttsilum Orma OGOOnto: Name of hardual or company Lewes Biork Falkn�lly Septic Service Phone 715-231-7375 Local gwenmpt unit 5}}.( p, �,�{yk'eg i�.,.��.. ,I {��Pn�oneaaft �ea�—.a�P�� LOwl government unit ptlrees �DdIal KAwk Ma--21Pall-9s- a Any defeONro Pan of Me Smith Shot be Federal arlyel d or rartaved pursuantW SPS 35351(1). Mc Adman CIXb Al or replacement of failed or Malfunctioning components shell come with sups M3, WSW Al Code No pool ter Chatir M pnYSmSl m toWb of the POWIS may M used unless approved by IMF demM em In accordance With SPS 384, Wnc Admin Code n ntinnnca Plan in any event bw any coded component of bolding all out be rpmred, a shall be replaced pursuant 0 a plan submitted to the appropriate Fuel, to renew and approval tam Mandomnenl If use of the tall is dncOnbnup, II shell he abandoned in accordance with SPS 383 33, Woo All Code WLP1200/800—MR TANK SPECIFlCATIONS Tw- VRcr aDRs vu Y eonw. r A ER 6' Y I.D VAECASf taIIXEK PoYR T ' 0,0 MWII _ _____ irF 141 11 Y Ms D D u T-A-z IIII I '' �T-A-� w.o �aii ii' wore eonw �zan Tea IIII RIET Np -1-3K M7 w EW& f151-A- \ \ �—' I DA4T'r. casT-A-Mu aooTw aaAi IIII I I iuzT um aura ARV mrtR m IIII SM, O II RArTLx E (0i STAT s aM* p uaw cwAom ab iiLM � )) 24 LoI CE9 , P R VRSATMATFD R i G wU A AIIt SL911L W. 4 M/ C s M/p0 r `aRT cow[ ux m� p (RV rem) ux p (wui rem) WSr Tue w WSRY 7N MTA 11E4i 0X}61E PUMP PAD ...w Mim Truck Alcrr,a I - SJb BI arms Page 1 of 4 Read here formformat ononshe as I, are A and raga re I M Covl o 19 IT Tank Alert ® AB Indoor Tank Alarm with Auto Reset and Battery Backup err®ale. provide ork,asanala n,Wno,annal,h,.aIOnnghpuue I Conditions 'he Tank part As lauto remr hat I cm a s andiumpud m a _ v nIinsite charners um pump assets holding tanks eeoge ognmlWrz I ad other voter If appf alarm coma _the horn sound, and as rm LEhr activates I he horn alarmcan j"urramd Off Of tire 1i01 nvraim onimar me mnaihoms ri (anc, the Or on iscibriva the alarm vall sub, ai reset Features -VA I e ,rr�, onr e • . R[Gahm-0ght gmmpost.. nn hart all ¢rtsnW and horn nla✓ssvach eeltlmete3t theala'rmcncer,form nroetooeamonthe hath,,back, p b�PatlS4 °�,1�'ll:.'k%'""�i ehT o'8g&aR'.'mryft: u�°°°:.C:3'9Pr�°�mh.amuxme...a.,�I.oaa.ewm.. n.wr • Ethernet block r i itch hem marked ism rated toIC an U ki l amp 9voind • so-n methods in she, rated a �a a„ Is, geand afor)II •a PW rnPR59kneto reduce the Pon, alIry oamock 'I ank AIII AB - SJB Uri Page 2 of 4 Options . W, um ar A..'..11 pn m m,vJ..Y_s<:<wi..n UL listed CSACerdfied Five Year Limited Warranty Specifications VOLTAGE FOR 120V MODEL I le VAC eai, 2,„,itoo Rmm mm,..r, BATTERY BACKUP POWER . vw ALARM ENCLOSURE. . 6.4i22S,r s L s la x s 16 i 572 in, NtMA I obn„ AIARM HORN . 87debelra130ke43Ai POWERCORD .6o-moem=arsl FLOAT SW I TCH CONNECTION TERMINAL exvo FLOAT SWITCH x m Ara Cli CAW e A tlet8�n12mq.nlw V 11, 111,1AIIII took 2 r �m . ,t,0 mA misolei Atlpoxrk,e,xnx.g a.wA .wooI .M I" A Ni m rv)ICC l rnNn w m AUXILIARY ALARM CONTACTS (Opoogo) KS(vehal" wnl Tank AlcrtW AB - SIP Rhombus Page 3 of Available Downloads sua . . vre r I n., a.., I 1M., .. V¢Ilou,00wnloadste<bnnof the webslte for additional hterao,e awar Alarm Systems / T Looking for support lal or purchase Information' 4osyIA T s Hole irm,aeeet, 1-888-342-5753, Notluct avr.rltaovc Locator `C°Uk,riit'A""°°"•�o..rr."Co t°.IMa,,..w.ft11W, oM i ..Im..I....Nl......111...."h'tIW..a.,,. sunno, cI, .o.. oI..woa�y f V & 10 Trunk Alerl® AU - till! RhomI Page 4 of 4 .orev 7a ui It 4 V-kh=-s Ah r POJL( Wlf"I'✓a-Of Fcnera. Crf sure so, u, rook as u I four orm son or Ma of expenenco, of our coft 0 efoa ouncour W furs M I us oo� oull mI " you ors trusto Parcel A. 002-10281 Valid as of 09121IM2002 54 PM AN. Parcelit 14 2916 YORK Owner And M ln9 Address TERRY M A RONDA L NELGESON 2533 CTY RD E WOODVILLE Al 54020 Dleblcb Abbrenele60escnpnon Acres 3111 SEC 14 T29N R16W IN NE NW LOT 1 CSM W1341 TOWN BALDWIN TOWN OF 9ALDWIN ST CROIX COUNTY. WISCONSIN COKN.neH•1 er PJ�ee�M ' 2533 CTY RD E Parcel Hil uur urcs vtlrvegr TYPO Pro OR 1 s lul CSM 051341 a]2-6t MIN*Law LOT Ol 2010 V•lue4ms' V hies Last Charged on 0MS2OID GL=ESIDENTIAL ]T10 332a0.W 2I3. W3.W 275900.03 Rod, UO �Geneta Pro 3-/]0 3220300 57 Woo1au,3 OW3 OW SheTJ an IDIP Genera 31]0 2A 1453 W — Y=nd . o00 000 men1nmes Taxes have not yet been Calcmaea Key Pinney ST. CROIX COLNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM OumvBufar ry 2 (! iIX Mailing Aeld/'�ress J� ) C_ij, ,1A1JlYAPLD t1(? ! Il/ Property Address �� l I , ,, 0, mflouton�row,eed NO I...as& Pommy b.panm[0 lm nI% ImttwOwn l L1 C1rylSmm IJQ./f/li Pnrccl Identification Number Wao-1022L LEGAL DESCRIPTION IF'/\� Progeny Location N2V^., yyT2::. See. L. T ZLN R(VW. Tovn of &AQLLn /1 Subdre lwom Plat J�I"f,<Nolhr2 Qt�r -I�NI U),;f—T .Lot M/P Cenine l Sum" Map y 3�GXY . Volume S . Pays a I Warranty Deed d before 2007)Volume .Payed Stake nou,, DyoOln I of Imes ldenoliable Cfc,om Imnmp,, ,nnm atpnr ouldrrnani npml re(vll" whandle x s Proper real pumping nth too scae tankx eD fame yeah CII'mm�nl. by a I'll",DO pmnmr W ban rou put Into ae IY11 awRi+lbe ail Of the lank a, Case e,r.pmeal y,len (Len numunamr ¢+punnlFalmee arc:PnviOW v195P5 )flr 53f p and �o(nna Coon.. Sonnvry Oiduwme e The Propm offaynv nubm o'd(nfix to np Planning A Z.mme O-famm atmnw mfonn ..yid I)Pea nd II I w ePIwLd.ou, l.man Plumber clod plmMu , ,nwd amateur m,noN,ltg that I I I the. wILL Jnpomif m on proteurItIng ImIlloon and or lil uAl f,,IPC Land pumping(If nttuwry l the Lone tans.. Iunn PILL,I doll IG1wit, I no the not Mabm rrywr ohe m%a age Julwl ne as the wMMa am Iwa hmin, a. Neta0 the DVMnmenl of son) And Peoleoidul Xrviw, aN the (hgmrmm of anonR ...paces mule or%vtwowm Cmdinnon wimp lho ew mpna ny. eem lus hrn m ml mul Lux M aompinN and mugged to lM A. Cron CwntPig n...g n m mp nmmi within }nd.r, or the three yea aeP^a ion 6ne owe o.m , lMl all stafrP nn do, came tin true an the ILL u(myOur kmwl.d, Irv, am are the aw oru) n(tA propeon Je+enh,d nMe, h, cuff, ofo adman Oul....reed in Repo ruf Deeds OOiee Number of bedd�rr0000ms 3 �y z EOF�APPLICAM1T(SI kDATE ?'ow An) m0mwunn late, muLlumIL of mulun the e+nnary permit Lane menkeL) M1)Ph. Planning h Zomry Dtiwnmem InluJwnb on, aPPL glen I r .. ho....rn dead finm Ph, R,ppuol OuJe IIITu om a my of N. temON cure.. map if «lean, I, made m the Ommi, de,J IRF.V. W Ill RECEIVED PPR 0 4 2003 SAFETY AND ealownoa wy N pFlallon Bumu Ia EW AmeSime ``� CROAW'NSPE TION REPORT OFF �iscon�Oxi Department or commerce Gory LNwnu semf ry Date ormspectmn. 1W14rz002 Plumper Nome and Adores Protect Name: XNBeeOn NA Use: RelmicemeM RaWvlOal Legal Description: NE, MW, 14, 29. IM Sma Number: Subdivision: Compared Soil Tesler Name and Address; Municipality: Term of Baldwin Henry F Crate, CST U27I4 County: St Cmis E4366353' Ave Menomonie, Wl 54761 Plan Transac9on Number: Summary Pemld Numbee pwler Wale andAddmF: Weatews rFlow: 450 pop loft Persons Plasma: H Come (' An crime rolls sepflutlon tees cpMWed at Me above Moreno] site as Per d9ntl paboy fa MI sXm xM low than four Indom of promotele] still Domw Me WXom of the A horizon. The IMam of truce Invagl adon Is to confirm InHlal oWervwlons W the warned soil taster (CST) relating to the presence or absence of ndmdmalphic %Mums In Me A moon and mosoll It sail teadure, structure, and corresponds factors team also revreaM as they Hints to wastewater eppeceflmn rates Olney site wndinon0 Bud, as percent add Mori 0 SIo ps landsrlpe award loop wnaes wmWr larggl, add surface water hydrology may also be noted and lhoor eFaC9 am (atlas mnsdemd m Me reccmmeWOEons and wnuuslons portion of this lepri It Is my opinion met sail wndMoru at this site an nwnads for a mound system using an ImelpMive determination r ,,,meld appears w ba very'.wt,N ne0 a e mene0 of auneble doll abode 0 amunted son common Redrolmorphlc facture were observed In the A-Iordson and ni iron concentrations and deplmimS weR ePoOrenIN(ne aubWll FMewtlarw$aW War ledepm OtherWdaMw Wlnepemelme priviar One option may be to conduct a sail saturation determination using preparing pipes during a nomal spi mason A haWlrg tank appears to be the only apron for a Wiedemann oruae ry m TM use of water poosetiong Mutes a hilt tacommeWop when a nesting Dank apnm A used If then am any questions regemlrq this rePoq seem contain me royG �y Vy tewaer delta Ljansky erLt nnam Emai 715FOW2548 Fax 715/720.25MVoice cc ®County ❑ Plumper ❑ CST ❑ Oxidation Omer_ / ?dy,,nQu.wa..:, 6r,d, cteasnsi aziS+ -CcuY,wIIIaligf1 riul j Key— ORIGINAL ,SB9 doormen OwMmsl N Oommace SOIL EVALUATION REPORT Page 1 9 3 wevewwuwntla filarcandallicall"al AYIsAdm CWe Vast Poll awes p VOO G¢unry pHeanepmenp.cw Ml®'Been B%a 11 nm a.X�w�.ma...p.Ine St Cri ,w na°'9u �.we.m.laNa . i. wIIISED Pol ll0 agz-+oza9g9BB Rr a.ewml.n mroXnavo rmP,m.�; Xmmaw>,„ma: 1»„�Ee. alarlawt Ar.ewee By ro PmpaM0.a'ner IT LR P 4>n Nel own rer isl NE IN NW+as 14 T 29 NR 15 W PmpeM Owrola Mel4np Pnorea BUW Xemew88W WE Vic Al so e,a. Pn,M Ni cur J WI.9¢ 9 Tmw "t �eCTXWE WmLvl:k 1 WI 5<028 115690-2983 Bal New Construcion Low M Poll f N.1cIV rf ciduramin, 5 Gm a...ae aeyn,saes 450 died sw Replammen1_Pulsemmem.l Pulse oraeoea _ n t'n - m 1_loessavarFoodsm Foods p.wooden do"ifiNA be Gno and mIcsirmentrameor, maiell qv 120 at cell mound on 977 for as upelope edge M ma sal 25' NanO fill -approved so saturation determined,, radial �Bonngr 0P1 Gound SUXau elev 977 a Oeeln to nmwm actor 10 in 1 1 N5 1 Wit 22 ml 3m 9e M* 0e Hill 2 5.10 IDYRm - ¢d 21 ask mvh HI J 10.15 10YP fl2 cap 10YR 65.5 ¢¢I meLk under if m¢on WkpeN lot norpad prountl welemuaerveu 1, BafiW Hot g 0 PH Cl Suisse elav 975 N Oepm 1, Imay fall 9 npoa x, ttpN wct C,M Rm,a Oewyum W Wm G.a ads Msy 0.0 10YR V2 ¢II 3mgr mvh � 9a H!/x 2 P1R t0YR R2 2110M fiR 21¢OF�IrMI 3 12i81 IVR 66 1 Mld>SYRSR I aid imol mull �1H - 1t 'l #1 - Boal 301220 miold TB$ 130 a 1% myL MImm W=BO formal T95_VprrgL LBi Nang lPWae Pnml g CBF Nuda I Xan Fe w n2774 va 0Men _ LonJWetl ee C Neede N Ave ,m,neW 92220021[n 710. v,Po.m 0.n, NN2 nTe _ v.,mi lo. W:-10:9.WOJII F ] ft • OP4 Gvw 5w wv 977 R DtMroILr4q Mw B m web CM w w Mm O.YGrt Wv OLA B We 'Ell.l Ew! ryB IOYRM YI Jmp rmlr P ift 5 B 3 5.10 IOYRM Q11VRW ( all ifW rrwr 1I 5 5 1615 10YRW m15]5YR S8 00 lmel 1I R 5 nn . memry e�mr m. a o®.,emi t c,, •v.x. a Iv. a,vm. ,.ewmo,pnm t..w,®mme e. nwm. >,mly Bm rvRub [m.srGb ��Lbta 1 [aYx QYA b.Jq £. ❑Bony/ B°^^e m O.pl, lolmVq iww__ N'MRY1b wPzmJwcK x i MP mJW WYW.Gb 6aM Cmbo I B+mW Rwt E!I 'Eryt 1' E •BWaa ]p. }pnp.{.MTSS a]9 <t50 myt �ESMnIR�BCQ.50 ngM1 ugi55 <yi^W lnr lkpnmm,of Commnn uxe9uJ oppwn,p zrvrte poagn W.mplopr I(Yaunmiwrs,v¢egzmizmmw mN muvN,nxJ,mw,r faemLL pN+ssmmw Ne Mpxmmtuw53E6113� or1TY 608�SH�5)11 t•I - a at t",� ST. CROIoX � u��Y PLANNING & Z®NNG March 19, 2008 Terry Helgeson 2533 Co Rd E Baldwin, WI 54028 Re Fading sanitary system at 2533 Co Rd E, Further described as (NEI/4, NW 114 Section 14, T29N R16W), (002-1028-90-000), Town of (Baldwin), ease. Mmurma" 71s3e646so Dear Mr Helgeson. yint"Mg m�' s The St. Croix County Planning and Zoning Department Is the'govemmental unit for 71s3eu.4674 the regulation of private sewage systems" m St Croix County pursuant to Section 14520(1)(at Wis Status Section 14520(2)(f), Wis. State States that the Fed PooDeny governmental unit shall investigate violations of Me private sewage system 71s389 4677 ordinance and shall issue orders to abate the violations. RL.3W )13uaef-46I5 Based on our records our Sanity Permit#420614 for a replacement holdingtank was never installed and expired on 12 lW04 This word inmates that the seemed septic system has been identified as a Category 1 failing system pursuant to Wisconsin Administrative Code Comm 81.01 (92) and Section 145,24M) Wis Scats Category 1 system are Nose which fail by discharging sewage to surface water, ground water, drain tiles, bedrock or a zone of seasonally saturate soils These are considered the most serious types of failure, and are given the highest priority for grant assistance The existing system is also considered a human health hazard as defined In Wisconsin Administrative Code COMM 81 01(128) and Section 254 01(2) Wisconsin Statutes A failing system can harm the environment by discharging sewage to the surface, N a lake or stream, or to groundwater The Soil Evaluation Report indicates that you have (0) inches of separation between the bottom of has private sewage system and groundwater. Pursuant to the St. Croix County Code of Ordinance, Chapter 12, St. Croix County Private Owns Waste Water Treatment Systems Ordnance, subchapter 12T (F)(4)(d) when a falling POWTS is identified it shall be brought into compliance with Wisconsin Statutes and Wisconsin Administrative Code. Any plumbing work real for comphance/replaang or remaining the failing system shall be performed by a plumber who is licensed in the State of Wisconsin. A list of plumbers is enclosed for your information. New technology is available that may be acceptable for your site. This technology utilizes a mound system during dry times of the year While sensors monfor the groundwater elevations and if these levels become We high the system will switch into a holding lank mode Rich Halverson from Black River Fails (215-284-2556) is the only plumber cuventiy approved to install this type of experimental System. A holding tank is still an acceptable option if that would hater fit your needs. St Cmlx County padmipates in the Wisconsin Fund Grant Program, which is a financial assistance program that assists property owners in replacing or rehabilitated failing private sewage systems All work, however, must be completed pnet to our submirong the application to the Department of Commerce to qualify for this grant If yeu are successful in recewing a grant through this program, a 5125 00 Admmistrative fee is due and payable to this office at the time you recene your grant award check A brochure outlining the general program Is enclosed If you feel you may quality, specifics of the program can be discussed further with you This letter constitutes an order to abate the above -referenced violation Contact me at 715-3864680 within 10 working days receipt of Nis latest to discuss corrective action. Failure to comply with this order am with the provisions of the SI Croix County Code of Ordinances. Chapter 12, St Croix County Private Onsite Wastewater Treabnent Systems Ordinance, or any order issued in accordance with this ordmance shall be Subjeol to a penalty as provided in Section 12 8 (B) (2) (a). Penalties include foffebares of not less than $10 per violation nor more than $1000 per violation savor be subject to injunctive relief Each day a violation exists is a separate violation Respectfully. y� Rar(tlon�g//bn'.y{v/� Zoning Technician Cc. Town of Baldwin File Enclosures Plumbers List Wisconsin Fund Grant Program Brochure ^^ez'^"•N^r L°m^+'m PRIVATE SEWAGE SYSTEM C�vlarw St Crd sureaewxapoi+wn INSPECTION REPORT ANI 0 OENERAL INFOR6IAYI6N UTTFCM TO PERMIp im W+w��avauanry v'wbrn•wn Paxvlr •�Sw Nxmy wr To- ns BalEwln Towlulll OOY-10]l-0OOW TANK WORMAVON ELEVATION DATA ��rn��� SYSTEM sa w�.etac crlrsa wpPl Lepn p¢m� SOR COVER apnlM .. o.Pnm �� ewrmm GnB, .nU[ax II MY. IA m IN v. IM xe COMMENTS prsluaemeaalloawneea, penonepmunt m) Impxmat___ m••mn n.___ Lp Hll2M3 Cnumy Nftdeft4.1l.Wl UMNEIA"10414 NRIW NALM1 Pv Rv. 14a.1U91B 1INtBM0.Wdpllm- 2lBxpM"Fr gm• -a to rover. Plenmwx N uM? IBIYee OW 1 SBovmrs sm a Ibmei rnfwm nw J emprySyep•e - Grtw N 9.eryr=IIdLnp wVmOe W.WNgovAw..F.D.aax4tR Cr,W s isconsin Da eRmBn[ol Commerce RLtlIm.M AM!-]IR -0i fle AALm Sanitary Permit Application . ma�uai. we .m.raa....,o.ian�..m. w.we+A, ❑ce.uxwmm � (o/�% I. APW®Ym wOlmBam-PIunPM .Ullelmmtl® .D. 75Z Flwp wxnx 3S 33rwDixcouxty n4 s/ xa tis. s.. eymw aw. mnxr. 11 wemame�twss .�"Ply) 6!�e� - S / Ck�n /3 S wore. ®i'a ❑ww�rnm��wm ��ux E 0.'1)pe el Pumlu M1.A f .pplbYe) ION.. a.p.mmsY..m l a<aam.ai e❑ ❑tra andee a.�ne,�r�wm ' ry ryprerxama: (a,.i.o we ygrylle •ht ..❑a.-.,...,,.,�� n❑ ❑....ate A❑ ... II❑nemwbcmm xe 4❑Sµw 510 2LSD a w s,m ea.w. tia.e. awmm �. a.am. n� oacw� YSd a_ .✓ .✓.A- Na .✓.� Na vA'r.w�wa Mw. w..a. va.m m� a� ei.mr ra. sw MOM r...w w,.e. wm�.m ime. euvLm'rAmw Rmn, Oy. eeYl u e xermm ❑ ❑ .++n e.mxa. a.a+..a..a..w misty a R.fm®IImaW fm aW Pr¢ .9¢dait /ex/z�/oz arg SEPTIC or HOLDING TANK SERVICING CONTRACT Contraa Dab —]This senator is madn e IbM his Tank Ontdt(f)Ndma(s) ere Pumpd'a Name S []RLa� Carols B n2 ae2.✓V wark coed Ire Insidlle o r (a) pepUahaat� Inp�oilsonvine pmpsrty: tPmviae local casompon) 1 The owner agrees to file copy of Ws contract with the local gwernmead was ill, Croix County Planning is Zoning Department) to document mamtemnce by a council sepuge semang operator as required in SPS 383 pollHc)2 Wis some Code and me approved Component Moved 3 The aware sgmi b lure the uptir/holdntg area) cmced by the undoni®ud ptoryer are itermcam Permit We romper b have seem are b exist uwn she property for the puryow ofsernang me egreesbmamum mad wdnvcw WtdiepwPycan Ihewe Fer,, tt the rapboll angles equipment.the width ehepumpinggmpmevL The) raw fmlly agna topayyt Charges incurred i and all aM1azgea mcurtetl in servrang Ne sepuctholtlrvguNfs)umuNally ageed upon by the owner and romper owner I The pampm agrees to about to we local government wit (St Croix County) a report for the servicing of 1M1ereptic/Iwldmgunk(alonamonthlyburs TMW^Petfmtherag swims eMefollowngin Ne numbly return The name and addm,s of mW he croon rnumm sble for cg te had.had.ialone holding . I The name of owner of the color holding twk. the location of the property On which be upmholding unk is meulled, d The summary Permit answer issued fur the upticimldlrq unk (if known), The oases On which me sepocNoldmg lank was worried, f The volume in gallon of We contents measure firm Ne sryuuToldmg look fur couch awaiting. a The Yspcvl ran to which We control, Mm We upnubolNry most were delivered] 4 That agreement will remain in effect will be uwnerwpumpertaminatea this contract lnucevesi range llt W(c rrevq etoownoecral raw (carrierWith mo mammual unit Were wnthbmNum bubusinessness days fromfom the deb of change to dnsxrvma contract oeslarlel Neme(d)IPnM1 T¢ffjrJl,Jl(J Owrydasigrmb s{e() SubQ eE and gewnwmay can this deb. ly.ia%a nn 11I 'fSOYIkI��P50/� ✓,.r- Tpdays orb lad 203.0 Pumpefs NeTs(Firm) Pu pals refer Nolery dlc SlBnatum /wry Rga�k Pumpafa......Y..... NumIKK fps+l.. Yoe Cwnmbcion F.pmeion SEPTIC or HOLDING TANK SERVICING CONTRACT e.a om ,e.mw wr..n ..RR,m.ri .e w.. 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